CPT code 27001 is for the incision of hip tendon, used to describe a specific surgical procedure in medical billing and documentation.
CPT code 27001 is the code used for the surgical procedure involving the incision of the hip tendon. This procedure typically aims to address issues related to tendon injuries or conditions affecting the hip, allowing for better access to the tendon for repair or treatment.
When billing for the CPT code 27001 (Incision of hip tendon), several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. Modifier 50 - Bilateral Procedure: Use this modifier if the procedure is performed on both hips during the same session.
2. Modifier 51 - Multiple Procedures: This modifier is applicable if the incision of the hip tendon is performed in conjunction with other surgical procedures on the same day.
3. Modifier 58 - Staged or Related Procedure: This modifier should be used if the procedure is part of a staged or planned series of procedures.
4. Modifier 59 - Distinct Procedural Service: This modifier indicates that the procedure is distinct or independent from other services performed on the same day.
5. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the procedure is repeated by the same physician on the same day.
6. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is appropriate if the patient requires a return to the operating room for a related procedure within the global period.
7. Modifier 79 - Unrelated Procedure or Service by the Same Physician: This modifier is used if a different procedure is performed by the same physician during the global period that is unrelated to the original procedure.
8. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right hip.
9. Modifier LT - Left Side: This modifier indicates that the procedure was performed on the left hip.
10. Modifier 22 - Increased Procedural Services: This modifier may be used if the procedure required significantly more work than typically required.
Each of these modifiers serves to provide additional context for the procedure performed, ensuring accurate billing and compliance with payer requirements.
The CPT code 27001 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS).
The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates. Additionally, the reimbursement for CPT code 27001 may vary depending on the local policies of the Medicare Administrative Contractor (MAC) responsible for your region.
It is essential to consult the MPFS and your regional MAC to determine the exact reimbursement details and any potential limitations or requirements.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level and by individual payer. With RevFind, you can identify discrepancies for CPT code 27001 and ensure you are receiving the correct reimbursements. Schedule a demo today to see how RevFind can help you optimize your revenue.
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